Some patients noted to have microscopic hematuria during routine Pap smears have only trace blood (2-3 RBCs/high-power field [hpf]), while others have 3+ blood (90-100 RBCs/hpf) with otherwise normal urinalyses. Should all these patients have full urologic evaluations?— ROBERTA ALSWORTH GONZALES, PA-C, Myrtle Beach, S.C.
Blood in the vaginal specimen is most likely due to menses or trauma from the procedure. The amount varies with proximity to menses. Blood on urinalysis is separate and not related.—Claire Babcock O’Connell, MPH, PA-C (152-11)